Pennsylvania
Pennsylvania Gov. Tom Wolf (D) announced that he is nominating Alison Beam to be the next Secretary of Health, with the departure of Dr. Rachel Levine to work in the Biden Administration. Prior to her nomination as the Secretary of Health, Ms. Beam served as the Deputy Chief of Staff to Governor Tom Wolf. She also previously served as the Chief of Staff to the Insurance Commissioner. In that capacity, Alison guided interactions with regulators, legislators, and national trade associations and developed and implemented internal response strategies.
Also in Pennsylvania. With Sec. Levine’s departure, Pennsylvania Acting Physician General Wendy Braund has issued an updated standing order for Naloxone for the general public, effective January 23. Please visit the above link for more information.
Lastly in Pennsylvania. Following the receipt of a letter NACDS cosigned with the PA Pharmacy Coalition, the Department of Human Services (DHS) issued a revised Medical Assistance Bulletin announcing they will pay the Medicare rate for the COVID-19 administration fees retroactive to December 1. Claims do not need to be resubmitted. The Bulletin also clarified that the pharmacy NPI should be in the “billing and rendering provider” field; however, they still require an MA-enrolled prescriber’s NPI in the “referring prescriber” field. Additionally, they’ve added CPT codes for the future AstraZeneca vaccine.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
In January, the South Carolina Enterprise Information System (SCEIS) will begin issuing 1099 forms to South Carolina Healthy Connections Medicaid providers. These forms will be for the calendar year 2020. In July 2019, the South Carolina Department of Health and Human Services (SCDHHS) transitioned the payment of Medicaid claims to the State of South Carolina’s consolidated accounting system, SCEIS. SCEIS requires payments to be issued to a single bank account for each taxpayer identification number (TIN), either a Federal Employer Identification Number (FEIN) or a Social Security Number (SSN). To make the transition to SCEIS, the South Carolina Department of Health and Human Services (SCDHHS) required Healthy Connections Medicaid group providers with multiple National Provider Identifier (NPI) numbers and/or multiple Medicaid Provider Numbers associated with a single TIN to designate one NPI and Medicaid Provider Number combination (a specific provider) to receive payment through SCEIS. The payments for all providers associated with that TIN were then made to the designated bank account for the NPI and Medicaid Provider Number combination. For more information on this transition, visit https://vip.scdhhs.gov/sceis/. In January 2021, SCEIS will begin issuing 1099 forms for the calendar year 2020 to Healthy Connections Medicaid providers. The 1099 forms will be issued to the NPI and Medicaid Provider Number combination designated by the provider and will include payments for all NPIs, and Medicaid Provider Numbers associated with the TIN. Providers will be responsible for any additional required breakdown of 1099 information. If you have any questions regarding 1099s for the calendar year 2020, please contact the Provider Service Center at (888) 289-0709.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Gov. Greg Abbott (R) will deliver his State-of-the-State address on February 1, 2021, to provide an update on the state’s response to the coronavirus pandemic and lay out his priorities for the 87th Legislature.
Also in Texas. the Prescription Drug Monitoring Program Advisory Committee held its quarterly meeting on January 19. The vendor Appriss shared information on the product enhancements to NarxCare program. The current statute requires all Texas licensed pharmacies are required to report all dispensed controlled substances C-II-V records to the PMP no later than the next business day after the prescription is filled.
Also in Texas. The Board of Pharmacy is scheduled to host a videoconference meeting on February 2, 2021. More information can be found at the following website: https://ldh.la.gov/covidvaccine/
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
HB 2079, sponsored by Del. Sam Rasoul (D) has been reported unanimously from the House Health Welfare and Institutions Committee. The bill would allow pharmacists to prescribe HIV Pep and PreP treatment; CDC immunizations to adults; tuberculin purified protein derivative for tuberculosis testing; and drugs, devices, controlled paraphernalia, and other supplies and equipment available over-the-counter, covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase the over-the-counter equivalent. A joint workgroup of the Boards of Pharmacy and Medicine would be charged with developing protocols for each. NACDS filed a letter of support for the bill which is an extension of legislation we were instrumental in passing in 2020 that allowed pharmacists to prescribe contraceptives and offer other therapies. The bill now goes to the full House for a vote.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
The Alabama Board of Pharmacy published a final rule to amend regulations under AAC 680-X-2 to revise parenteral sterile therapy requirements to reflect the renewal cycle. The rule also requires pharmacists performing high-risk sterile compounding to complete an additional 4-hour, board approved high-risk program. In addition, the rule requires sterile compounding pharmacists to complete 2 continuing education hours each renewal cycle. The rule is will be effective on February 14, 2021.
Also in Alabama. The Board of Pharmacy published a final rule to amend regulations under AAC 680-X-2 to revise preceptor training requirements to reflect the renewal cycle. The rule is also effective on February 14, 2021.
Also in Alabama. Effective immediately all references to “Reenrollment” will be replaced with the term “Revalidation” to match current Medicare terminology. These changes will be made to all future letters sent to providers referencing the re-enrollment program/processes as well as information contained on the Provider Enrollment website. Providers are also now able to begin uploading their completed revalidations through the secure provider web portal. Additional instructions for uploading revalidation applications and documentation can be found on the Provider Enrollment and Form page under the Revalidation section on the Medicaid website here.
Lastly in Alabama. The Board of Medical Examiners posted a proposed rule to adopt regulations under AAC 540-X-26 to establish requirements for collaborative practice between physicians and pharmacists. The rule would add requirements for collaborative drug therapy management agreements, standards for physicians, reporting, patient care protocols, and the formulary. Comments are due February 4, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
The Legislature convened on Monday, January 11, and is expected to last 60 days
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services (DHCS) Medi-Cal is on track for April 1, 2021, to move from managed care to fee-for-service. DHCS has received approval from the Centers for Medicare & Medicaid Services (CMS) for numerous projects, including the transition of the Medi-Cal pharmacy benefit from managed care to fee-for-service. For more information about Medi-Cal Rx, please visit DHCS’ dedicated Medi-Cal Rx Transition website: Medi-Cal Rx: Transition
Also in California. DHCS submitted a State Plan Amendment (SPA) 20-0046 to CMS, which seeks to set reimbursement for COVID-19 testing administered to Medi-Cal students in schools at 70 percent of the Medicare reimbursement rates. The effective date of this SPA is February 1, 2021.
Also in California. The California Department of Public Health released new guidance on vaccine prioritization on January 7. The guidance recognizes the need to balance the prioritization of scarce vaccine resources to achieve community immunity for all Californians by noting situations in which the health departments and providers may offer doses promptly to people in lower priority groups, including provider flexibility to eliminate vaccine spoilage.
Also in California. The Board of Pharmacy reminded pharmacies that they must register their mobile vaccination clinics/hubs where their pharmacist and pharmacy technicians are providing vaccinations outside the pharmacy. All that is required is the pharmacy name and license, and records related to vaccinations should be kept at the pharmacy to be made available if needed for an inspection. Chain companies can provide one list of all their licensed pharmacies in California where there is a mobile COVID vaccine clinic or COVID vaccine administration outside the pharmacy. For more information contact Amber Dillon at Amber.Dillon@dca.ca.gov.
Also in California. The Board of Pharmacy provided guidance on new compliant security prescription forms for instances where a prescriber may not have utilized a compliant security prescription form for a controlled substance on and after January 1, 2021, as required by Assembly Bill 149 (Statutes of 2019). For additional information, go to the Joint Statement and FAQs from the California Department of Justice, the California State Board of Pharmacy, and the Medical Board of California.
Also in California. On January 7, the Office of Administrative Law (OAL) approved the Pharmaceutical and Sharps Waste Stewardship Program Regulations, which are effective immediately.
Also in California. The Administration’s Medi-Cal reform initiative that got delayed last year due to COVID was revised and released last week. The CalAIM executive summary is attached and here is a link to the website.
Lastly in California. In case you missed it, before the holidays, the California Department of Consumer Affairs (DCA) issued an order waiving restrictions on pharmacy technicians related to administering COVID-19 vaccinations with specific conditions: DCA Waiver DCA-20-103 Order Waiving Restrictions on Pharmacy Technicians Relating to Administering COVID-19 Vaccines.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Legislature convened on Wednesday, January 13th for a 120-day session, and is scheduled to adjourn on May 12.
Also in Colorado. The Department of Health Care Policy and Financing (HCPF) Department’s substance use disorder services (SUDS) is now available to Medicaid members effective January 1, 2021. More information can be found here.
Lastly in Colorado. The Board of Pharmacy will hold a virtual public hearing on January 21, 2021, on a proposed rule revising pharmacy standards for refrigerator and freezer storage, allow pharmacy technicians to administer immunizations, and simplify the recordkeeping requirements for pharmacists and pharmacies relating to vaccine administration.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
The Board of Pharmacy will hold a Public Hearing on February 23, 2021, on a proposed rule that would expand the board-authorized conditions allowing prescriber-approved protocols for dispensing of medications or other services to include alcohol use disorder; colorectal cancer prevention and screening; HCV infection screening; HIV infection prophylaxis, pre-and post-exposure; and HIV infection screening. Please send your comments by February 16, 2021, to jmccormack@nacds.org for inclusion in NACDS’ letter of support.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
As one of the eight members of the Louisiana Pharmacy Congress, NACDS participated in a virtual meeting hosted by the Board of Pharmacy to discuss interim study reports and proposed pharmacy legislation for 2021. Issues discussed were payment parity, expanded scope, collaborative practice agreements, and expanding access to immunizations. The Louisiana Department of Health gave a presentation on their new initiative called “Well-Ahead Louisiana,” a program aimed at partnering with pharmacies to manage chronic diseases. More information on the Well-Ahead initiative can be found here.
Also in Louisiana. The Board of Pharmacy’s Regulation Review Committee is convening a virtual Zoom meeting on January 26, 2021. The meeting access information is provided in the header of the agenda. Links to the legislative and regulatory proposals scheduled for consideration during that meeting are available at the Board’s website, in the Rulemaking Activity section of the Public Library.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Medicaid Office of Pharmacy Services issued an updated Bulletin about pharmacy billing for COVID vaccinations in the fee for service program. Please visit the above link for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nevada
The Board of Pharmacy adopted a final rule revising standards for electronic transmission of prescriptions, adding provisions on exemption certificates, and defining “technologic or electronic failure. The rule became effective on December 29.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
The state moved past COVID Phase 1A, which featured vaccinating frontline healthcare workers and residents and employees at long term care facilities, to Phase 1B. Consequently, persons 76 years of age or older, those 15 or older with underlying medical conditions that place them at greater risk from COVID-19, frontline essential workers who cannot work remotely, educators and other school employees, and vulnerable populations such as those at congregate care facilities are now eligible to join phase 1A in getting vaccinations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
This week, the Ohio Department of Medicaid (OCM) awarded the contract for its Single Pharmacy Benefits Manager to Gainwell Technologies. Please see ODM’s news release for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
On January 23, 2020, Centene Corporation acquired WellCare Health Plans, Inc., which included WellCare of South Carolina, a managed care organization (MCO) contracted with the South Carolina Department of Health and Human Services (SCDHHS). As a result of this acquisition, WellCare will no longer participate in SCDHHS’s Healthy Connections Medicaid managed care program. Effective April 1, 2021, existing WellCare Medicaid members will be served by Absolute Total Care. Absolute Total Care is a wholly owned subsidiary of Centene Corporation. WellCare will remain responsible for claims, appeals and hearings, and other administrative processes that occur before April 1, 2021. To satisfy its contractual requirements with SCDHHS, WellCare will keep administrative processes in place for at least 12 months after exiting the Healthy Connections Medicaid managed care program. Providers rendering services to WellCare members will continue to work directly with WellCare for all dates of service before April 1, 2021. Additional administrative information may be found on WellCare’s website.
All Healthy Connections members transferred to Absolute Total Care on April 1, 2021, will maintain a continuity of care period for up to 90 days during which time members will continue to receive all authorized services from their current providers. If providers have questions about how this acquisition may affect them, they should call WellCare Provider Services at (888) 588-9842 or Absolute Total Care Provider Services at (866) 433-6041.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Legislature convened on Tuesday, January 12, and immediately elected a new Speaker of the House, Republican Dade Phelan from Beaumont.
Also in Texas. The Texas Department of State Health Services (DSHS) instructed the Centers for Disease Control and Prevention (CMS) to ship first doses of COVID-19 vaccine to 28 hub providers for large community vaccinations of health care workers, people 65 and older, and anyone 16 and older with medical conditions that put them at greater risk of hospitalization and death from COVID-19.
Also in Texas. The Medical Board adopted a final rule establishing the process and circumstances under which physicians may obtain a waiver to be exempt from requirements for electronic prescribing of controlled substances.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Emergency Regulation allowing pharmacists to initiate treatment for Naloxone, Epinephrine, Hormonal Contraceptives, Prenatal vitamins, and certain OTC meds under protocols are currently in effect as of January 3. The protocols and other documentation forms needed can be found here. As you will recall, these regs are the result of the passage of HB 1506 last session, a legislative priority for members that NACDS was instrumental in passing.
Also in Virginia. The Pharmacy Technician Registration Emergency Regulation became effective January 3. The Board of Pharmacy expects to have an online registration portal operational next week and will email licensees when it is available for technician trainee registration. However, certification is not required to register as a technician until July 1, 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
Please find attached the Alabama Medicaid ALERT for pharmacy billing of the COVID-19 vaccine administration (you can also find the ALERT here).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Florida
The Division of Disease Control published an emergency rule to adopt regulations under FAC 64DER20-44 to authorize redistribution of the COVID-19 vaccine between vaccine providers within the state. The rule specifies that providers must receive approval from the Florida Vaccines for Children and Adults Program and requires tracking of vaccine redistribution between enrolled providers. The rule is effective December 17, 2020 and expires March 17, 2021.
Also in Florida. The Board of Pharmacy published a notice announcing its intentions to amend regulations under FAC 64B16-33 to establish a rule regarding the international export pharmacy permit and to develop and incorporate an application. Comment due date is not specified.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Department of Healthcare and Family Services issued a provider notice with billing and reimbursement for pharmacies administering COVID-19 vaccination. Please visit the above link for additional information.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Department of Public Health has added new documents to its COVID-19 website pertaining to pharmacy, including billing and reimbursement information for administering the COVID-19 vaccination and updates to the statewide standing order as of December 30.
Also in Iowa. the Department of Human Services issued a final rule amending regulations to allow automatic prescription drug refills, with participation in such a program being voluntary and opt-in only, on a drug-by-drug basis, and to establish standards. The rule is effective on March 1, 2021.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Kentucky
The Board of Pharmacy published an emergency rule to allow pharmacists, pharmacy technicians, and pharmacist interns to order and to administer vaccinations to children between the ages of three and 17 in response to the COVID-19 pandemic and to comply with federal standards under the PREP Act. A hearing is scheduled for February 23, 2021, via teleconference and written comments are due February 28, 2021. The rule became effective November 23 and expires August 20, 2021.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maryland
Gov. Hogan (R) issued an Executive Order (EO) on January 5 requiring providers to report the administration of COVID-19 vaccines within 24 hours. The EO states that employers of providers share joint and several responsibilities for compliance with the order and includes penalties for non-compliance. Please visit the above link for more details on the Executive Order.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
Earlier this year, Governor Charlie Baker (R) signed into law SB 2984 which among other things, recognizes pharmacists as health care providers. Please visit the above link for bill language.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
Gov. Gretchen Whitmer (R) signed into law SB 920, which provides regulatory relief through the remaining course of the state emergency declaration. Provisions include emergency refills, therapeutic interchange, and remote supervision of technicians and other staff. Most of these provisions were lost previously when Gov. Whitmer’s Executive Orders either lapsed or were invalidated by the State Supreme Court.
Also in Michigan, the Department of Health and Human Services issued a bulletin with coverage and reimbursement information for pharmacies administering the COVID-19 vaccine. Please visit the above link for more details on the bulletin.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.